Women with Disabilities: Barriers and Facilitators to Accessing ...

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WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublincomponent headings that define ‘access to services’: availability, accessibility,accommodation, affordability and acceptability. The review did not consideraccess of women with disabilities to general health services, personalassistance and care issues, the effects of poverty and social exclusion, orwomen and disability in general as the NDA has previously commissionedreviews in these areas. All research referred to in this document is disabilityspecificand throughout the report the term ‘women’ refers to women withdisabilities unless otherwise stated.5. Key research findingsThe key findings from this review of Irish and international literature were:5.1. General findings• Maternity care in Western society has become increasingly medicalised,which has led to a diminution of emphasis on the importance of women’sexperiences during pregnancy and childbirth.• Sixty-three percent of a sample of 500 mothers from the generalpopulation in Ireland were unhappy with aspects of their care duringpregnancy or birth.• In Ireland, approximately 38,000 females between the ages of 18 and 44years have a disability of some type.• Evidence from the literature suggests that society has, in manyinstances, undervalued women with disabilities and the care of womenwith all types of disabilities shows a history of discrimination that lasts tothe present day.• It would appear from the literature that society has exerted control overthe sexual and reproductive lives of women with disabilities and,particularly in the case of mothers with intellectual or mental healthdisabilities; there is often a presumption of risk to the child whether or notthere is evidence of such risk.xi
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublin• Adverse societal attitudes such as these may very well lead to barriersfor women with disabilities in accessing suitable services in pregnancy,childbirth or motherhood.5.2. Findings in relation to women with physical disabilitiesBarriers for women with physical disabilities were found in relation to:• accessibility, related to the location and models of care, difficulties intransport and moving around the physical environment• accommodation, centred mainly around the lack of provision of suitablehealth information and less so around difficulties with communication• acceptability, in terms of lack of knowledge and negative attitudes andbehaviours from staff.Facilitators to access for women with physical disabilities were more difficult toascertain from the published literature, but some were found in relation to:• accessibility, relating to improving access to buildings and services, withsome emphasis on developing ease of movement around the physicalenvironment• accommodation, focussing on the provision of sensitive antenataleducation classes• acceptability, noting that considerable work on developing healthprofessionals’ knowledge of, and attitudes towards, physical disability isrequired.5.3. Findings in relation to women with sensory impairmentsBarriers for women with sensory impairments were found in relation to:• accessibility, which focussed mainly on the difficulties of orientation tothe health care setting, completing registration forms, locating a seat inthe waiting area, and realising when to go into the examination room• accommodation, which centred mainly around communication and healtheducation, where women with hearing impairment, in particular, were at agreat disadvantagexii
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